Individual
ELASHA LAVONE LEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8377 HUNTINGTON CT, CONWAY, SC 29527-7989
(180) 319-9523
Mailing address
PO BOX 1376, CONWAY, SC 29528-1376
(180) 319-9523
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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